February 5, 2014
Host: Ted Simons
- The U.S Senate passed a new farm bill. The Agricultural Act of 2014 will provide farmers and ranchers certainty for the coming year. Arizona Farm Bureau president Kevin Rogers will talk about what the bill means to Arizona farmers.
- Kevin Rogers - President, Arizona Farm Bureau
| Keywords: government
Ted Simons: U.S. Senate passed a new Fife-year farm bill yesterday. Earlier approval by the house means the bill is on President Obama's desk. Arizona Farm Bureau president Kevin Rogers is here to talk about what the bill means to the farmers here in the state. Thanks for coming.
Kevin Rogers: Appreciate the opportunity.
Ted Simons: New five year farm bill, after a whole lot of fussing and fighting they finally got something done. Your thoughts.
Kevin Rogers: It's about time. One of few things Congress has to do every five or six years is pass a farm bill. For USDA, farmers and ranchers and for the citizens of this country. We have to be feed. We have to grow the food, make sure it's safe, nutrition, affordable. This tells us what the next five years are going to hold as far as what the government is going to do.
Ted Simons: I was going to say, that certainty for farmers is pretty important.
Kevin Rogers: It is. As we negotiate with our lenders, we're business just like anyone else, we go to our banks every couple years and say this is what I hope to produce; this is what I hope to sell it for, lend me the money. If that negotiation, we need to understand there's insurance programs, target prices, what's there if the worst case scenario happens and we run out of water or in the Midwest they don't get rain or the drought. Whatever happens we need to understand what's at play.
Ted Simons: So the agriculture act of 2014, what does this farm bill do?
Kevin Rogers: Well, it's obviously just been passed by the Senate. Hopefully the president is supposed sign it tomorrow or Friday. We're getting pieces of it as it comes out because things change all the time. It gives us stability in the future for the next five years. It tells us that livestock disaster has money set aside if you think back to this late fall we had those cattle up in the Dakotas that froze in place and ranchers lost hundreds of thousands of dollars. They have been out on their own without any support. At least now we understand that there's disaster money there for different things that could happen across this country. Really the food nutrition is a big part of the farm bill, 75%, more of a food bill than a farm bill. The agriculture part of this is only about to 12-15% depending on what you classify as production AG. A lot of money for research, a lot of money for grants, for technology. Out in the west we grow good crops in this soil. Everything is irrigated, so we don't have the seasonal risk that they may have in the Midwest but we rely on technology heavily.
Ted Simons: Talk about those risks. There's criticism regarding the subsidies. Now it kicks in when the farmers suffer losses. Is it more of an insurance plan?
Kevin Rogers: This new bill is moving towards and insurance plan. That's one of the changes that's come about. Really, we're pleased that Congress has acted on anything. When you think about what they do back there and what they are supposed to do we're tickled there's a bipartisan vote and now hopefully they can do other things that are important to us. But when there's a need, when there's a short time, that's when that safety net should kick in and it's important we be able to feed our country. I would hate to think I'm relying on Hugo Chavez or someone around the world to feed us or send us food. It tells the citizens of this country we'll be able to feed ourselves. We'll be able to grow crops here. If the worst skies scenario happens and we have a disaster there will be funds to keep the farmers in business, not to make a profit, just to pay the bills and live to fight another day.
Ted Simons: Some critics thought the spending was too high or possibly too high. They call a bait and switch situation because the costs will escalate. Bad weather, falling markets. The costs could escalate more than perceived right now. Is that a real threat?
Kevin Rogers: Well, there's always the unknown. However, you write a farm bill for the worst case scenario. When we go to Capitol Hill we talk about the worst case. What if I total the car, do I have coverage? That's pretty much the game plan going in. I don't see an opportunity for it to go much worse than it is. In fact every year we have always given money back to the federal government as far as U.S.D.A. They get appropriated so many dollars at the end of the year. If you don't have those disasters, if the cotton price is up, milk stays where it's supposed to be, the U.S.D.A. has the money to returns back and we don't talk about it that much.
Ted Simons: Sounds like there's more in this bill that will save money over the years.
Kevin Rogers: As we move away from direct payments to an insurance based program in Arizona we grow a lot of cotton. As we figure out what insurance product is there for some of the commodities we grow including our vegetable folks that have never been in that cycle now there's an opportunity for a product to be developed for our vegetable folks, we'll learn more about that, but much like you buy insurance for your cars and your homes, it's there for worst case scenario and the government helps fund part of that but then the farmer can buy up that premium if he feels he needs more than the base amount.
Ted Simons: There's been a lot of fussing and fighting over this and it's taken a long time to hammer out this compromise. A lot of folks are not happy with it which probably means it's a good compromise.
Kevin Rogers: We have some people that have never been happy with the farm bill, some of our friends, Mr. Flake, Mr. McCain, they don't support the expenditure, having those dollars there for a rainy day fund. We have to feed this country. Every day we go to the grocery store you want to make sure there's food on the shelves to purchase.
Ted Simons: Senator McCain called it a monstrosity. That's his word. Too many subsidies for farmers, too much duplication in terms of subsidies and nutrition programs. Does he have a point?
Kevin Rogers: They cut the nutrition package almost $10 billion from where it was and where it has been. When you look at the Senate version it was eight to 10 billion. The house wanted to cut 40 billion. They ended up with eight, where the Senate was. Obviously Mr. McCain was in the minority of that. It takes a long time to clean up what you're doing. Most of the savings is based on making sure that people qualify for those things, things you and I take for granted that we expect folks to do don't always happen. So qualifications of those funds are watched very closely.
Ted Simons: As far as Arizona farmers are concerned the farm bill in general, just in particular, conditions out there. We're in a drought. We have water concerns. What's going on with the farming community?
Kevin Rogers: Everyone's looking to see what the future holds. We need rain. We need snowpack this winter. We desperately need the reservoirs to get some water. The Salt River Project needs to be filled; the Colorado River System needs to come up. Agriculture is some of the first to get cut in a drought. The drought is probably number one on our radar along with forest health. That's our watershed that has to hold the water for us. If it's burned off and not taken care of correctly that becomes an issue too.
Ted Simons: This is my last question, quickly, the farm bill, food stamps are a huge part of the farm bill and obviously you're a farmer and you have your concerns. Does the fact that perhaps fewer people will get food stamps, does that concern you as a producer?
Kevin Rogers: Well, it comes back to need. Those who need it should be able to get it and qualify for it and part of what we do is make sure the gleaning programs in this valley across the state are tremendous, conservation that happens in agriculture is tremendous. Yuma is the lettuce capital of the world. People are harvesting it and giving it to food shelters. You hate to see people go hungry, so we expect our government leaders to make sure those who need to be fed get fed.
Ted Simons: Kevin, good to have you here.
Kevin Rogers: Thanks so much. Appreciate it.
Ted Simons: The new year finds Arizona hospitals facing a number of new issues, including the affordable care act and a hospital price transparency law. Joining us now is Greg Vigdor, president and CEO of the Arizona Hospital and Healthcare Association. Good to have you here.
Greg Vigdor: Good to be here.
- With the New Year, Arizona hospitals are facing new issues, such as the Affordable Care Act and hospital price transparency, which requires hospitals to list prices. Greg Vigdor, the CEO and president of the Arizona Hospital and Healthcare Association, will discuss new issues hospitals are facing in our state.
- Greg Vigdor - CEO and President, Arizona Hospital and Healthcare Association
| Keywords: government
Ted Simons: Arizona Hospital Association. Talk to us about the group.
Greg Vigdor: We're the trade association fort hospitals across the state and other health systems. We're trying to provide leadership on the many health issues we face as a state.
Ted Simons: Among the issues I'm sure you're looking at now is the affordable care act, better known as Obamacare, and the health exchanges therein. Talk to us about the early impact on hotels.
Greg Vigdor: We don't have a lot of real data because of the obvious problems with the rollout of the website. It's moving slowly in terms of enrolling people. For hospitals when people need care is when they are going to come, so it's not automatic that they enroll and then come to us. We're not seeing much more than anecdotes. We are seeing the beginning of enrollment,we're seeing people come in for care but it's early and relatively slow so far.
Ted Simons: What about the Medicaid expansion here?
Greg Vigdor: A little bit faster, in Medicaid there's correlation of people needing health care and efforts to enroll people. We have a much greater capacity than the federal government did to do it right. We're a bit more optimistic. The impacts on the hospitals remain to be seen. Our hope is it's going to help with the uncompensated care problem in both cases, but we don't have any data yet.
Ted Simons: Uncompensated care was the big factor as far as hospitals were concerned it seems to me. No indication as yet? Any hints that what you are concerned about is actually being addressed?
Greg Vigdor: We did our modeling before the bill this. Was the numeric reason we got involved in it. We know when we go back to when enrollment moved backwards after the great recession that hospital and compensated care doubled by roughly $400 million. We do expect we'll see some benefits from that, but it's only part of the reason we did this. It's also a better way to deliver care to people.
Ted Simons: What about federal reimbursement as far as Medicaid patients?
Kevin Rogers: That's also a problem for us. The hospital field across the nation agreed to over $100 billion in cuts and $3.7 billion were in Arizona. We have been dealing with realty we have to cope with. The problem is every time Congress or the administration comes up with something new they say let's funds it with more cuts. We're now staring in the faces of another 1.3 billion. That's difficult for us. We're saying enough is enough.
Ted Simons: Like 70% now? Is that the level as far as how much a hospital has to pay?
Greg Vigdor: That's in terms of Medicaid payments a rough number. Medicare is higher. Over all it gets back to the uncompensated care number.
Ted Simons: Another concern I would think would be higher deductibles. A lot of what goes on with the affordable care act is the opportunity to take whatever deductible you want. Once they get into a rough situation and they can't pay the bills, concern for you.
Greg Vigdor: Right. These are some of the real questions with the affordable care act. It's what happens after people mayor their selections. Do they know they are choosing a plan where they are responsible for the payments? Do they understand who is in the provider networks? These the emerging issues in the state. We're seeing troubling signs but our job is to manage them, take care of people, figure out how to make it work.
Ted Simons: Troubling signs unexpected?
Greg Vigdor: I don’t think so, not to those of us in the business and saw what was happening.
Ted Simons: What about the idea, again, affordable care act means more people with insurance means more people getting health care means more doctors are needed? Concern?
Greg Vigdor: It is. Especially in primary care. Not exclusively there. We have a shortage in Arizona. I think other parts of the country they may talk about this as a problem. Here it's much more acute. We are going to have to look at the capacity question pretty seriously. I think we'll have to do some policy and other solutions to try to make what we expect to happen work.
Ted Simons: I think the worry is if you can't find a doctor, not enough doctors, boom, back in the emergency room for a cold.
Greg Vigdor: Exactly.
Ted Simons: All right, there's a new hospital price transparency law. Talk to us about this. What it does and how it can best serve folks without confusing the heck out of them.
Greg Vigdor: People are confused with good reason. There's no justifying the way we have set up our pricing systems. It's an artifact of how policy is developed in this country, no policy, really this. Is an effort of the legislature to find a way to give people information they can use. Our members are working to try to work through how we can comply with the law. We hope it works, but I think it will be incomplete for folks because we don't control their insurance contracts. I think they really care about what they have to pay and if they have a deductible plan we don't have that information. We have to try to make that work but find other solutions and fix our payment system.
Ted Simons: Is there a website up and operational now that compares with hospitals of a certain size compares basic procedures?
Greg Vigdor: It's not a website in our state's case. We have an obligation under law to basically provide the public posting. It can be through a website for the hospital or other means. In our state in terms of this bill we don't have that type of solution.
Ted Simons: DHS does has a website?
Greg Vigdor: There are some solutions where that's being developed. We try a voluntary effort in our association to do that.
Ted Simons: It shows the charge for the procedure and what that procedure costs the hospital?
Greg Vigdor: For the most common procedures, the prices charged.
Ted Simons: But it doesn't include doctors' fees, right?
Greg Vigdor: Right.
Ted Simons: It doesn't include the insurance negotiations that go on.
Greg Vigdor: Right.
Ted Simons: So how do you know what's going on?
Greg Vigdor: We have to figure out a way to help people understand what's going on. We believe in transparency. We have to fix this. That's clear. This may do some good. That's why we're going along with it but we have to find better answers, not just in Arizona. This is a national problem. To get this back where it needs to be we have to find a national solution.
Ted Simons: Are you okay with the idea of a best average and below category ranking for hospitals?
Greg Vigdor: If done right we're ready to stand by accountability measures but ones that are fair and allow for improvement and again, more than anything, are transparent enough so people can understand them. Many of the sites are so complex and complicated people get more confused.
Ted Simons: As far as quality of care, out comes, patient experiences, these are categories listed on the DHS. You're okay with that as far as metrics are concerned?
Greg Vigdor: Yes, improving upon metrics and upon our performance. We're committed to that in this association.
Ted Simons: I know the hospital association was not all that excited about this transparency law when it was being debated. The first was vetoed by the governor. The second goes through but there were concerns.
Greg Vigdor: We thought it would be a waste of time. The bill is much better I think again it's incomplete solution.
Ted Simons: As far as regulatory oversight for this transparency bill for this kind of transparency, what do you think?
Greg Vigdor: If it helps I think we're willing to talk about it, but again, if it's a regulatory oversight of something not being productive for the citizens of the state that's a different matter.
Ted Simons: Before you go, again, the impact of federal cuts to Medicare. We talked about Medicaid. Talk to us about where that stands. What you're concerned about.
Greg Vigdor: The $1.3 billion we're staring at as far as future cuts. Enough is enough. We have to make sure the things we're doing in this country are not coming out of the hides of hospitals. We have to pass it on or have even greater uncertainty in the healthcare system. We already have enough going on in this state with the other things.
Ted Simons: Are you optimistic when it comes to transparency, when it comes to ACA, Medicare reimbursement, are things move in a positive direction to you think?
Greg Vigdor: I'm confident the leadership of our hospitals and their commitment to try to make it work. These are not all our preferred solutions but the obligation for us to take care of people and patients. Why complain about them? Let's just make it work.
Ted Simons: Good to have you here.
Greg Vigdor: Good to be here.
- Luige del Puerto of the the Arizona Capitol Times will give the latest news from the State Capitol in our weekly legislative update.
- Luige del Puerto - Journalist, Arizona Capitol Times
| Keywords: legislative
Ted Simons: Good evening. Welcome to "Arizona Horizon." I'm Ted Simons. A state lawmaker's curious travel habits are raising eyebrows at the capitol. Luige Del Puerto of the Arizona Capitol Times has more in our weekly legislative update. Thanks for showing up. Did it take you -- how many thousands of miles to come here?
Luige del Puerto: Thousands and thousands.
Ted Simons: What is going on with Don Shooter travel expenses? Run us through this thing.
Luige del Puerto: He raised a modest amount last year, about 43 thousand dollars in campaign finance contributions. What drew people's attention is the fact that he has spent a lot of money and most of it went back to him. He had reimbursed himself a total of $ 19,000 from his campaign finance account from last year. Of that amount, about $17,000 was for travel expenses. That raised a lot of eyebrows. That's because what's really interesting about this report is that had he reimbursed himself for fuel and also for mileage. As you know in government and the private sector, the usual practice is just to reimburse yourself for mileage, but it appears that he's reimbursing himself for fuel and mileage. At the same time he's also getting exactly getting reimbursed from the state for his travel expense. We're not sure exactly if he is asking for money for the same travel that he's already getting paid for by his campaign. We're not sure about that. There's no way to reconcile based on state records unless he details those expenses.
Ted Simons: In 2013, which is not an election year, he spends $38,000 on his campaign, in a nonelection year. $18,000 for campaign travel expenses, on top of the $8,000 he gets from taxpayers for being a lawmaker from out of the area, correct?
Luige del Puerto: That's correct although I would like to say there's nothing illegal about this one, that we know of. I spoke with the state -- Secretary of State Official and they said there's nothing in state statute that restricts how you use campaign funds. In effect you could use them for travel expenses or for your legal defense, which is exactly what he did.
Ted Simons: Exactly. $15,000 for legal fees defending a school incident. Again as part of campaign expenses?
Luige del Puerto: That's a very good question. That's one of the things that I really want to ask him, if he somehow starts to talk about what this particular controversy is. But you're right it is raising a lot of eyebrows. He's reimbursing himself a lot of money and there are some campaign expenses that don't seem to be directly related to his campaign. For example, paying for his legal defense in that school case, for example.
Ted Simons: So how this is playing? Does he have a primary challenge?
Luige del Puerto: Shooter does. It's a businessman named Toby Farmer, out of, if I'm not mistaken, Litchfield Park. Today, his opponent seized on this, says this guy has a lot of explaining to do and he should explain why he's in effect taking money from his campaign funds for travel expenses even when he's already getting money from the state. Like I said, we don't know because we can't reconcile this based on the records whether he's asking for the state to pay for the same travel expense that's already been paid for by his campaign.
Ted Simons: Mr. Shooter is still head of the Senate Appropriations Committee and that’s a pretty power position. No sign of him being excused from that?
Luige del Puerto: It is a very influential position.
Ted Simons: Before we go, some fund-raising money, looks like there was concern that the pro Medicaid expansion or restoration if you want to call it that, the lawmakers for that get hit hard in the primary, they wouldn't be able to raise funds. Sounds like they are raising quite a bit of funds.
Luige del Puerto: As you know, last year there were district party -- I'm sorry Republican parties at the district and County levels that had censured them. They have been warned they will be Primaried the last year they raised the moment amount from all the candidates. Incumbents and nonincumbents alike. Nine out of the top fund-raisers are members of the bipartisan coalition that approved the Medicaid expansion.
Ted Simons: As far as money being raised, primary can't be used in general or can primary be used in general?
Luige del Puerto: The people know this. Candidate, these incumbents know they can't transfer anything beyond $2,000 from their primary to the general unless they fix a law passed last year that said this is the only amount that you may transfer from between your committees. That is only up to 2,000 bucks.
Ted Simons: If you we're running for governor and you raise $500,000 in the primary, and right now $490,000 just sits there when the primary is over.
Luige del Puerto: Assuming suddenly you don't have a primary opponent. You're going to be in a whole lot of pain. It can't be transferred.
Ted Simons: As a former politician here said, it gets curiouser and curiouser. Thank you, Luigi.
Luige del Puerto: Thank you.